• Journal of The Korea Institute of Healthcare Architecture
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• v.23 no.3
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• pp.81-90
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• 2017

Purpose: The regional trauma center should be a trauma treatment center equipped with facilities, equipment, and manpower capable of providing optimal treatment such as emergency surgery to a severely traumatized patient upon arrival at the hospital. In order to establish a medical system for effective severe diseases, it is necessary to prepare architectural planning guidelines for the regional trauma centers. Methods:: Analyze the spatial configuration, and the area composition of the regional trauma center, And to provide basic data for building a more efficient regional trauma center. The spatial composition analysis divides the space into initial care, resuscitation, patient area, nursing area, diagnostic test, staff training, staff support, public, and analyzes the area and interconnection of each space. Results: The area that must be included in the regional trauma center is the resuscitation area, the patient area, the diagnostic examination area, architectural planning should be designed to enhance the interconnection of the areas. IIn addition, a regional trauma center should be planned as a separate from the existing facility so that it can be installed and operated independently. Implications: A regional trauma center should be built as a stand alone operation and the space should be planned as a more efficient route.

• Proceedings of the Korea Contents Association Conference
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• 2013.05a
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• pp.209-210
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• 2013

본 연구에서는 보건복지부에서 중증 응급환자를 위한 '중증질환별 특성화 센터'로 지정된 안양의 H병원에서 오토바이 사고로 인해 응급실을 내원하여 중증외상 환자로 분류된 환자를 대상으로 보건복지부 중앙응급의료센터에서 정한 중증외상 등록체계를 바탕으로 중증도를 분석하여 손상기전과 생존의 영향을 미치는 인자에 대하여 알아보고자 한다.

• Journal of the Korea Convergence Society
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• v.12 no.4
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• pp.285-291
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• 2021

This study is a retrospective study attempted to determine the factors that influence the survival of patients with traumatic acute subdural hematoma. The study subjects were 207 patients with traumatic subdural hematoma who visited the emergency room from January 2017 to February 2019 at C University Hospital in G Metropolitan City. Data analysis was using the SPSS 23.0 program, and χ2-test, t-test, and logistic regression analysis. As a result of the study, the factors affecting the survival of the subjects were under disease, complications, and initial GCS. Therefore, it is necessary to establish a medical system to check the subject's history and to train medical staff to prevent complications. In addition, it is necessary to improve the transfer system so that the GCS of the subject can be measured from the stage before transfer to a medical institution and transferred to a hospital that can be treated quickly.

• Korean Institute of Interior Design Journal
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• v.26 no.6
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• pp.172-179
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• 2017

The regional trauma center should be a trauma treatment center equipped with facilities, equipments, and manpower capable of providing optimal treatment from emergency surgery to a severely traumatized patient upon arrival at the hospital. In order to establish a medical system for effective severe diseases, it is necessary to prepare architectural planning guidelines for the regional trauma centers. This study analyzes the connectivity, control, integration, and mean depth of current trauma centers using the convex map of space syntax, And to provide basic data for building for more efficient regional trauma center. The major areas that must be included in the regional trauma center are trauma resuscitation room, trauma operating room, trauma intensive care unit, and trauma general ward. It is necessary to carry out the architectural planning to increase the interconnection of the four areas. Also, the elevator plan for trauma patients should be emphasized. In addition, a regional trauma center should be separated from the existing facility for independent operation. According to the case analysis of the space configuration of the regional trauma center, the location of the operating room is most important considering the connection with each department of the hospital and the treatment flow of the severe trauma patients.

• Journal of Chest Surgery
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• v.39 no.2 s.259
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• pp.127-133
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• 2006

Background: In the studies of the distribution of time to death in trauma patients, the early deaths within several hours after injury were a large component of total trauma deaths. Due to the development of trauma system, overall mortality of trauma was decreased, but trauma is still the major cause of deaths. Material and Method: From January 1994 to December 2003, trauma patients who had been admitted and had expired at tertiary hospital were enrolled. There was a total of 400 cases, a retrospective study was done to determine the distribution of trauma mortality according to the part of the body that were severely injured part and compared the difference between early deaths within 6 hours and late deaths after 6 hours. We also analysed the risk factors of early deaths due to trauma. Result: In severe injury to the head and abdomen, the distribution of mortality was bimodal. But, in severe chest injuries, the distribution was log-shape and most early deaths were almost of trauma related. The average of GCS were 5.86$\pm$4.15 for the early deaths and 8.24$\pm$5.02 for the late deaths (p < 0.05). The AIS of thorax were 2.66$\pm$1.87 for the early deaths and 1.55$\pm$1.76 for late deaths. The risk factors for early mortality were non-EMS transportation (odds ratio 3.474), high AIS (odds ratio 1.491) and GCS (odds ratio 0.859). Conclusion: In trauma patients, the causes of early mortality were severe brain injury and massive hemorrhage. Also severe chest injuries were the major cause of the early deaths in truama. Early diagnosis of chest injury can frequently be missed in the acute trauma setting. Therefore, high index of suspicion, a careful examination, and aggressive surgical treatment are important in multiple trauma patients.

• 한국노년학
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• v.37 no.2
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• pp.293-308
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• 2017

This study aims to examine Life Managers for Elderly People Living Alone (LMEPLAs) in Seoul regarding their traumatic experience and the status of their posttraumatic stress disorder and also how they are coping with it in order to find out ways to improve it. As a study method, we investigated LMEPLAs in Seoul through a self-administered survey regarding whether they had faced any traumatic experience, types of their traumatic experience, diagnosis on posttraumatic stress, and the status of their coping with traumatic experience. According to the study results, 186 respondents (37.57%) have been found to indicate either partial or complete posttraumatic stress symptoms, but the status of their coping with it is very poor. The followings are the results of our discussion. First, it is needed to find out life managers suffering from posttraumatic stress disorder and build up a system to manage them consistently. Second, it is necessary to vitalize education about traumatic experience and posttraumatic stress management. Third, it is urgently needed to build up a system to support life managers who have faced any traumatic experience or been diagnosed to have posttraumatic stress disorder. Fourth, it is demanded to cultivate and arrange experts equipped with specialized knowledge and technique. Fifth, it is needed for them to build a network with medical institutes to receive a prompt diagnosis and specialized treatment.

• Journal of Digital Convergence
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• v.17 no.11
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• pp.547-556
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• 2019

The purpose of this study was to investigate the relationship between post-traumatic stress and depression in veterans and to examine mediating effects of ego-resilience in relation. Data were collected from 383 subjects of National Merit of the Korean War or Vietnam War with the cooperation of the Daegu Veterinary Association from March to June 2018, and the collected data were analyzed using the SPSS 24.0 Statistics Program to analyze the mediating effects of ego-resilience in post-traumatic stress and depression with hierarchical multiple regression. Post-traumatic stress was found to be high in the case of long absence(F=7.97, p<.001), unemployment(t=2.09, p=.040), poor economic condition(F=64.49, p<.001), and ego-resilience as a parameter in the relationship between post-traumatic stress and depression. Based on the results of this study, it is required to develop various programs focusing on improving ego-resilience and systematic management at the national level in order to intervene in depression of veteran.

• Smart Media Journal
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• v.13 no.5
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• pp.33-44
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• 2024

Chungbuk has various regional characteristics in terms of population composition by region, industrial facilities, and distribution of emergency medical institutions. However, there are no studies yet that have analyzed regional characteristic factors related to the occurrence characteristics of cardiac arrest patients. Therefore, this study provided basic data to establish a response system for OHCA patients suitable for the characteristics of the Chungcheongbuk-do region by analyzing the characteristics of OHCA patients and the transfer status of 119 paramedics in Chungcheongbuk-do. This study is a retrospective study that analyzed 1,188 cardiac arrest patients transferred by ambulance based on raw data from the survey on acute cardiac arrest in Chungbuk (2020). There are a total of 11 emergency medical institutions in Chungbuk-do, which are concentrated in city-level areas, so the transfer time of patients to hospitals in county-level areas was delayed. In the county-level area, the frequency of dispatch of special paramedics was relatively small, and the frequency of administration of cardiac arrest drugs to help resuscitate cardiac arrest patients was also low. In conclusion, efforts should be made to improve accessibility of emergency medical services (deployment of emergency vehicles in marginal areas, proper placement of emergency medical institutions, etc.), to promote prevention of traumatic cardiac arrest patients, and to expand the scope of work to strengthen the first aid expertise of paramedics.

• Journal of Trauma and Injury
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• v.24 no.2
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• pp.89-94
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• 2011

Purpose: A few studies have assessed the factors affecting the prognoses for major trauma patients and those improving the circumstances when dealing with the trauma system. In that light, we analyzed factors, such as pre-hospital factors, the time to admission, the length of stay in the emergency department (ED) and emergency operation, influencing the outcomes for trauma patients. Methods: The patients who visited our emergency department from April 1, 2009, to February 29, 2011, due to major trauma were enrolled in the study. The inclusion criterion was a revised trauma score (RTS) < 7 or injury severity score (ISS) ${\geq}$ 16. We used reviews of medical records, to analyze each step of emergency medical care with respect to patients' sex, age, visit time and visit date. Continuous variables were described as a median with an interquartile range, and we compared the variables between the survival and the mortality groups by using the Mann-Whitney U test. Fisher's exact test was used for nominal variables. Using the variables that showed statistical significance in univariate comparisons, we performed a logistic regression analysis, and we tested the model's adequacy by the using the Hosmer-Lemeshow method. Results: A total of 261 patients with major trauma satisfied either the RTS score criterion or the ISS score criterion. Excluding 12 patients with missing data, 249 patients were included in this study. The overall mortality rate was 16.9%. Time to ED arrival, time to admission, time of ED stay, RTS, ISS, and visit date being a holiday showed statistically significant differences between the survival and the mortality groups in the univariate analysis. RTS, ISS, length of ED stay, and visit date being a holiday showed statistical significance in the multivariate analysis. Conclusion: The mortality rate did not show a significant relationship with the time to ED arrival, use of 119, on time to admission. Rather, it elicited a quite significant correlation with the trauma scoring system (RTS and ISS), the time of ED stay, and the visit date being a holiday.

• Journal of Trauma and Injury
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• v.24 no.1
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• pp.25-30
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• 2011

Purpose: Major trauma patients should be transferred to a definitive care facility as early as possible because prompt management will prevent death. This study was designed to discover the obstacles leading to delayed transfers under the current emergency medical system in Korea and whether there are any negative outcomes associated with conducting procedures at primary care hospitals prior to transferring patients to higher levels of care. Methods: The medical records of major trauma patients with an Injury Severity Score above 15 within the past year were reviewed. Patients were divided three groups as follows: (A) came directly to our emergency center, (B) were transferred without CT or MRI scan at the primary care hospital and (C) transferred with CT or MRI scans. The transfer time of each group were compared and analyzed statistically. Additionally, the number and type of imaging performed at the primary care hospital were analyzed. Results: All qualified patients (n=276) were enrolled in this study: 121 patients in group A; 104 in group B; 51 in group C. There was a statistically significant difference in the transfer time between the three groups (p-value<0.001), and 79 (28.6%) were transferred to an emergency medical center within one hour. In group C, CT or MRI scans were performed an average of 1.86 times at the primary care hospital, and the median transfer time was 4 hours 5 minutes. Conclusion: Only 28.6% of the cases in the study arrived within the golden hour at a definitive care facility. Such delays are in part the result of prolonged times at the primary care hospital for radiologic examinations, such as CT or MRI scans. Major multiple trauma patients should be transferred to a definitive care facility directly or as soon as the primary survey and the resuscitation of Advanced Trauma Life Support guideline are completed at the primary care hospital.